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Erschienen in: Notfall +  Rettungsmedizin 2/2011

01.03.2011 | Originalien

Herzinfarktnetzwerk Region Augsburg (HERA)

Einjahresergebnisse

verfasst von: Dr. C. Thilo, A. Blüthgen, B. Kuch, W. von Scheidt

Erschienen in: Notfall + Rettungsmedizin | Ausgabe 2/2011

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Zusammenfassung

Hintergrund

Das Register des Herzinfarktnetzwerks Region Augsburg (HERA) untersucht prognostisch relevante Therapiezeitintervalle nach (über)regionaler Netzwerketablierung zur Akutintervention bei ST-Strecken-Hebungsinfarkt (STEMI) an einem Maximalversorgungshaus in gemischt städtisch-ländlicher Struktur.

Material und Methoden

Es wurden 250 konsekutive STEMI-Patienten vom 1.5.2007 bis 15.5.2008 eingeschlossen. Prognostisch relevante Therapiezeitintervalle sowie das Vorhandensein eines 12-Kanal-Elektrokardiogramms (EKG) und die Medikation am Einsatzort wurden von Not- bzw. Klinikärzten standardisiert dokumentiert.

Ergebnisse

Die „pain-to-contact time“ betrug im Median 71 min, die „contact-to-door time“ (C2DT) 56 min, die „door-to-balloon time“ (D2BT) 65 min und die „contact-to-balloon time“ 121 min. Insgesamt 80% der Patienten mit primärer Notarztversorgung hatten eine D2BT von <90 min. Bei 82% der Patienten wurde vom Notarzt ein 12-Kanal-EKG angefertigt. Eine Reduktion der D2BT wurde durch direkte Übergabe im Herzkatheterlabor erreicht.

Schlussfolgerungen

C2BT und D2BT sind niedriger als in den meisten publizierten Studien und Registern und kommen den Vorgaben der Leitlinien nahe. Die Vorgabe des/der American College of Cardiology (ACC)/American Heart Association (AHA) einer D2BT von <90 min bei >75% aller Patienten wird bereits erfüllt. Eine weitere Reduktion der D2BT wäre möglich, insbesondere durch direkte Patientenübergabe durch den Notarzt im Herzkatheterlabor. Dies setzt jedoch die verlässliche STEMI-Diagnose am Einsatzort mittels 12-Kanal-EKG voraus.
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Metadaten
Titel
Herzinfarktnetzwerk Region Augsburg (HERA)
Einjahresergebnisse
verfasst von
Dr. C. Thilo
A. Blüthgen
B. Kuch
W. von Scheidt
Publikationsdatum
01.03.2011
Verlag
Springer-Verlag
Erschienen in
Notfall + Rettungsmedizin / Ausgabe 2/2011
Print ISSN: 1434-6222
Elektronische ISSN: 1436-0578
DOI
https://doi.org/10.1007/s10049-010-1335-6

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